New Jersey Department of Banking and Insurance Approval Letter

For a detailed copy of the Decision Point/Pre-Certification Plan, go to www.statefarm.com/claims/decrevew.pdf

Conditional Assignment of Benefits- for Standard and Basic Policies with endorsement 6126H

Internal Dispute Resolution Request Form
Internal Dispute Resolution Physician List

For additional resource materials and information go to www.statefarm.com/claims/njpip.htm

Provider Networks

	Raytel Imaging Network
	Atlantic Imaging Group
	ProFit